[Inpatient behavior therapy of depression--a multimodal approach in clinical practice]

Using a reinforcement-oriented model of depression, we applied a multimodal approach of behavior therapy in clinical setting. We modified the self-control-group-therapy of psychoreactive depression, developed by Fuchs und Rehm (1977) in order to reach applicability for inpatients of psychiatric hospital. Operant techniques, social skills training, self-control-techniques, and the cognitive techniques developed by Beck (1979) were used. In contrast to Becks cognitive therapy we emphasized both the motivational aspect of depression and the aspect of self-regulation and self-modification too. There was not only the therapist trying to change behavior, thinking, and feeling of the patient by cognitive techniques. The patient himself tried to develop cognitive and behavior coping strategies. The treatment of patients with severe depression in an early stage was controlled by the therapist, later on they learned to control themselves. A central point of the concept of self-modification is teaching well founded knowledge of behavior analyses to the patient. Self-modification is not very efficient without, and the patient's motivation to work on his own therapy is elevated significantly. In some cases we continue this form of therapy after the patient's leaving the hospital up to three months.